Remote Nurse I - Hospital Bill Audit

Job Overview

We are seeking a meticulous and experienced Registered Nurse to join our team as a Hospital Bill Audit Nurse. In this pivotal role, you will ensure the accuracy of hospital billing by conducting thorough audits of medical records and confirming that services are appropriately documented and charged according to established industry standards. This position offers the flexibility of remote work, with occasional travel required to provider locations for onsite audits.

Key Responsibilities

As a Hospital Bill Audit Nurse, you will be responsible for:

• Coordinating and managing assigned audit tasks, ensuring timely communication with the Audit Coordinator.
• Performing onsite audits at provider locations when necessary.
• Reviewing medical records to verify the accuracy of billed services, identifying discrepancies such as overcharges, undercharges, errors, duplicates, and unbundled items.
• Maintaining meticulous and accurate records of findings in compliance with standardized documentation practices.
• Ensuring adherence to HIPAA regulations, confidentiality policies, and internal guidelines.
• Reporting any challenges encountered during the audit process to supervisors for prompt resolution.
• Collaborating professionally with both internal teams and external providers to represent the organization effectively.
• Undertaking additional tasks as assigned by management.
  
  

Required Skills

To thrive in this role, candidates should possess:

• A solid understanding of hospital billing and charging processes, including UB-04 forms, itemized bills, revenue codes, CPT/HCPCS codes, and ICD-10 coding.
• Familiarity with CMS, payer guidelines, and relevant industry standards is preferred.
• Proficient computer skills, particularly in Microsoft Office (especially Excel), and the ability to participate in virtual meetings.
• Exceptional attention to detail and organizational skills to ensure accurate audit results.
• Strong verbal and written communication abilities to facilitate effective collaboration with teams and clients.
• Advanced critical thinking and decision-making skills to navigate fast-paced and challenging environments.
  
  

Qualifications

• An Associate Degree in Nursing or higher is required.
• An active RN license in your state of employment is necessary.
• A minimum of 5 years of clinical experience as a Registered Nurse in OR, ICU, or ER settings is preferred.
• Previous experience in medical bill auditing is an advantage.
• Experience in hospice care would be beneficial.
  
  

Career Growth Opportunities

This position not only allows you to utilize your clinical expertise but also offers a valuable pathway for professional development within the healthcare sector. By joining our team, you will have the opportunity to enhance your skills and advance your career in a supportive environment.

Company Culture and Values

Our organization is dedicated to fostering a culture of professionalism, precision, and teamwork. We prioritize a collaborative work environment where employees can thrive independently while contributing to billing accuracy and compliance.

Compensation And Benefits

This role offers a competitive compensation range of \(60,846 - \)90,940, depending on experience, location, and qualifications. We provide a comprehensive benefits package that includes healthcare, paid time off, and retirement savings options, ensuring our employees are well-supported.

Employment Type: Full-Time